In December 2017 the Margaret Pyke Trust’s event “A win-win for human and environmental health: How conservation programmes can be strengthened by meeting family planning needs” featured in the magazine Resurgence & Ecologist. David Johnson and Carina Hirsch of the Trust wrote about the event itself, and the work of Population & Sustainability Network members in the field. The article is duplicated below, or you can read it on the website of Resurgence & Ecologist.
Irene, a resident of Tampolove village, in a remote and arid part of Madagascar, was still at school when she had her son. With little to no access to health care, she would have had to walk 30 miles to the nearest clinic to access a modern method of contraception. Women like her were having on average seven children, and faced a 1 in 20 risk of dying in pregnancy or childbirth – many thousands of times higher than in the UK. The population of the region was doubling every 10 to 15 years, placing increasing pressure on fisheries, and couples were struggling to catch enough fish to feed their families.
So women sought help from an organisation working in the area: Blue Ventures, a marine conservation social enterprise that works in many remote communities that often rely almost entirely on fishing for their livelihoods. “Women were telling us how they desperately wanted better access to family planning services, and because we were already partnering with these communities on livelihoods and natural resource management initiatives they turned to us for help,” said Vik Mohan, medical director at Blue Ventures. “So we took what felt, at the time, like a bold and unconventional move [for a conservation organisation], and we opened our own family planning services in the community.”
Since then, Blue Ventures has trained local women like Irene to work as community health workers, and has partnered with Marie Stopes Madagascar, which offers long-acting methods of contraception and provides more complex care. A partnership between the conservation and health sectors, integrating sustainable livelihood and family planning actions, has provided opportunities to engage women in natural resource management, and men have become more supportive and involved in reproductive health.
Vik told Irene’s story at an event organised by the Margaret Pyke Trust as part of the Family Planning Summit held in London. The event, titled ‘A Win-win for Human and Environmental Health: How Conservation Programmes Can Be Strengthened By Meeting Family Planning Needs’, focused on a critical and yet often overlooked issue.
The global human population is increasing – in Africa, it is projected to quadruple from over 1 billion today to around 4 billion in 2100 – with the overwhelming majority of growth taking place in regions facing particularly complex development challenges, including poverty and inequality, environmental degradation, ill health, and a range of other related social problems. The ability of any nation to respond to these problems is further exacerbated when there are a significantly greater number of people whose health, education and social needs must be met.
While rural areas are, almost invariably, of greatest conservation significance, they are also the areas that, generally speaking, have higher rates of population growth. This is in part due to the greater barriers to family planning information, rights and services. People living in remote rural areas are also more likely to rely most directly on their local environment and natural resources for their food, water, livelihoods, medicines and building materials. When population growth impacts on the health of the ecosystem, it therefore also affects the health of rural communities. Reproductive health and rights are critical, not only for the health and empowerment of girls and women, but also more broadly.
Despite this demographic reality, many conservationists have been reluctant to consider population and family planning when developing conservation policy and programme design, but there are positive signs this could be changing.
There is an approach used in the development sector known as Population, Health and Environment (PHE), which recognises this connection. The model addresses the complex connections between families, their health and their environment by combining sustainable livelihood generation with family planning work. PHE is particularly appropriate for people living outside the reach of health-care systems, in sensitive rural areas.
Speaking at the event on the sidelines of the Family Planning Summit, Kristen Patterson of the Population Reference Bureau said: “The PHE approach is one proven method of holistic development [bringing together] conservation and reproductive health actions simultaneously.” She shared her own personal experiences of living in Niger, where she saw first-hand the connections between population, health and environment, and how that changed her perspective on the world.
A review of 10 years of PHE implementation carried out by the United States Agency for International Development sheds light on key benefits of PHE programming, including that communities are often quicker to feel invested and get involved, and that short-term results tend to lead to longer-term sustainable impact. By responding to people’s most pressing needs, PHE projects foster greater local trust and help build local ownership.
One example can be found in Groot Marico, in the North West Province of South Africa. The project, named by the locals A Re Itireleng, which means ‘Let’s do it ourselves’ in the Setswana language, is run by Margaret Pyke Trust, Pathfinder International and the Endangered Wildlife Trust. It was designed to meet the need for sustainable livelihoods in the context of climate change and insufficient access to family planning.
In the heart of the project area are the headwaters of the Marico River, a watercourse of regional importance. A healthy Marico River is critical for the survival of endemic and vulnerable species, and to sustain the livelihoods of the largely agricultural community. Downstream many other communities rely on the Marico River, as do the ecosystems through which its waters flow, such as Kruger National Park.
The area and its inhabitants are increasingly threatened by droughts and the demands being made on water supplies by a growing human population. The Endangered Wildlife Trust had been working in the area for some time, providing training on sustainable livelihoods to enable conservation-focused agriculture practices including water harvesting and permaculture principles, when local people identified the need for greater access to family planning services, and the programme evolved into a PHE project. By themselves, neither environmental livelihood actions nor family planning actions could adequately respond to the interrelated challenges. The community and ecosystem need PHE.
There are hundreds of millions of people like Irene living in sensitive and remote rural areas where human health and wellbeing are closely associated with ecosystem health, where access to healthcare is limited, and where communities rely on the local environment for their food and water security. Many of these areas, such as the coastal communities where Blue Ventures works, and the Groot Marico community, are also particularly vulnerable to the impacts of climate change. Population growth, which is in part due to barriers to family planning information and services, exacerbates all these challenges.
But change is possible. Today, Irene makes a comfortable living growing seaweed and sea cucumbers through an initiative supported by Blue Ventures, and is a passionate advocate of family planning in her village.
Programmes like these have changed people’s lives for the better. So why aren’t more environmental organisations and funders responding to these development concerns with integrated approaches? The reality is that most development aid is funded in silos, and most conservation and health organisations lack the cross-sectoral expertise necessary to work simultaneously in these sectors.
For too long, conservation and human development agendas have been distinct from and even in competition with one another, failing to address the critical relationships between people, their health and wellbeing and the environment. The 2030 Agenda for Sustainable Development, set by the United Nations in 2015, and its 17 Sustainable Development Goals were hailed as integrated and transformative. PHE programmes are one way to make sure that integration happens and we achieve those goals. It is an approach that we hope and believe will become substantially more common in the coming years. That can only be good news for both human and environmental health.
On 11 December 2017, in Tshilwavhusiku, Limpopo Province, South Africa, a celebration was held, marking the official launch of Nndwakhulu. “Nndwakhulu” is the TshiVenda phrase for “the big fight is on!” The people of Tshilwavhusiku’s fight is to combat sexual, reproductive and gender human rights violations.
With 449,624 Euros of European investment, Network member the Thohoyandou Victim Empowerment Programme (TVEP), and Network coordinator the Margaret Pyke Trust, are working with the communities of Tshilwavhusiku and Midoroni to know, understand, advocate for and exercise their sexual and reproductive health rights. TVEP, whose long-standing status as a champion promoting communities’ sexual and reproductive health and rights is well known, are also partnering with the local Tshilwavhusiku Victim Empowerment Programme (TsVEP), to transfer skills and ensure the impacts of Nndwakhulu are long lasting. Representatives of the European Union, and local government officials, joined the people of Tshilwavhusiku to help celebrate the launch.
Sarina Mudzwari of TVEP said, “I clearly remember the community discussions when the communities were talking about what they wanted to name their project. There was a passion and understanding that they needed and wanted to stand up, and fight against, human rights abuses, that they have rights to healthcare and must exercise them, that it was time to change, and so Nndwakhulu began.”
Mr Raul de Luzenberger, the EU representative, is extremely supportive of the project, “We are very proud to be supporting such a significant effort to address gender based violence and ultimately, empower rural community members, especially women and girls”.
The launch was an exciting moment for all involved, featuring a drama performance, song and dance, speeches from dignitaries and with an inspiring and uplifting poem being read. Community members celebrated the results they are already seeing on the ground.
Although 11 December 2017 was the official launch, project actions commenced earlier in the year. Tshilidzi, a community member who has attended the training sessions, said “I am so grateful to be learning about my rights, no one had ever explained to me what they are, where I can access family planning, who I can turn to in case of abuse, now I know and I can stand up for myself!”
The contents of this publication are the sole responsibility of The Margaret Pyke Trust, with the Population & Sustainability Network and can in no way be taken to reflect the views of the European Union.
Excerpt from nEUws: DSW's EU newsletter - edition 331, November 30, 2017
On November 21, the Committee on Development (DEVE) of the European Parliament adopted an opinion on ‘women, gender equality and climate justice’.
Thanks to joint advocacy efforts on behalf of the Margaret Pyke Trust and DSW, in its opinion, DEVE ‘Calls for the identification and reinforcement of specific gender-sensitive strategies that support the gender and social dimensions outlined by the global climate authority, the Intergovernmental Panel on Climate Change (IPCC), including voluntary, rights-based family planning as a potential adaptation strategy’.
DEVE further ‘Stresses the need to identify and promote programmatic approaches that have been proven to be gender-responsive, such as population, health and environment (PHE) programmes, among others, that provide an integrated solution to health, gender and environmental challenges, including a response to climate change, and contribute to the achievement of the respective sustainable development goals (SDGs)’.
The opinion will inform the Parliament’s position on this topic, a process led by the Committee on Women's Rights and Gender Equality (FEMM), and which will be voted on December 4.
We’re pleased to announce that Dr Marian Davis has joined the team of Network coordinator, the Margaret Pyke Trust. Marian will be focusing on improving health services, including sexual and reproductive health services, for young people in south-west Uganda.
Dr Davis, who has over 30 years’ experience in adolescent healthcare, joins us from Herefordshire, where she has set up a number of young people’s clinics in schools and ran a young people’s clinic at her GP practice for over 20 years. Marian is also experienced in delivering health services in low-resource settings, including Syrian refugee camps and Uganda.
“Young people face a multitude of issues, from puberty to sexual health, to peer pressure and mental health, and specialised youth services provide the support they need to thrive, at what is a difficult time in their lives” explains Marian.
Youth focused services provide young people with an opportunity to access a wide range of services from one place. “They might come in initially to show you a sore foot but after a short time speaking with them, they are more likely to mention an issue at home or at school that’s been bothering them” explains Marian, “or they might want to access sexual health services at the same time, as it’s a more discrete location than, say, attending a specialised sexual health clinic, which might be more embarrassing for them.”
Marian will be developing youth-friendly healthcare training to be implemented, at first, in and around Bwindi Community Hospital in south-west Uganda. Dr Davis will also be assisting us to develop integrated population, health and environment training materials, benefitting the community surrounding Bwindi Impenetrable Forest National Park. This project forms an important part of the Network's population, health and environment advocacy.
“We’re delighted that Marian has joined our team. She brings a wealth of experience that will strengthen our work and ensure young people are able to access vital healthcare services”, said Margaret Pyke Trust Chief Executive, David Johnson.
Read more about Marian on our staff page.
Climate change is one of the key investment areas that has been identified by Women Deliver’s Deliver for Good Campaign. Deliver for Good is a global campaign that applies a gender lens to the Sustainable Development Goals and promotes 12 critical investments in girls and women to power progress for all. For the second year running, The Margaret Pyke Trust has provided the feature article on this theme marking the opening of the annual global climate change conference, COP 23, beginning today in Bonn, Germany.
The recent publication entitled Drawdown: The most comprehensive plan ever proposed to reverse global warming, details the top 100 solutions that have the greatest potential to reduce emissions or sequester carbon from the atmosphere. The team of over 200 scientists and researchers behind the publication have modelled and detailed 21st century solutions to a 21st century problem, namely those that benefit the environment and society in a variety of ways. It is therefore not shocking (at least to those of us in the sexual and reproductive health and rights, and gender sectors) that girls’ education and family planning rank 6th and 7th respectively on this comprehensive list of solutions to save the planet, sitting well ahead of many infrastructure and energy related solutions, which are the most widely known climate change solutions.
For women to have children by choice rather than by chance and to plan and space their family size is a matter of dignity, autonomy and empowerment. At the Margaret Pyke Trust, with the Population & Sustainability Network, we advocate for those 214 million women and girls around the world who are not able to choose- because of either cultural norms, myths, attitudes of clinic staff or needing to travel long distances to reach their nearest health facility- to name but a few barriers to family planning that women face. In Sub-Saharan Africa, 21% of women and girls have an unmet need for contraception, while Southern Asia is home to the largest absolute number of women and girls who lack access - 70 million. The United Nations Population Fund estimates that 24% of women and girls in Uganda and 14% in Niger have an unmet need for family planning.
Access to voluntary and rights-based, quality family planning information and services is not only essential to women and girls’ health and empowerment but also has the potential to make a significant contribution to sustainability- including adapting to and responding to climate change.
High levels of unmet need in developing countries (see map of the 69 FP2020 focus countries here) account for some of the population pressure felt in these countries and risks undermining their hard won development successes as population growth outpaces development efforts. Incidentally, many countries with high levels of unmet need are also already affected by the severe effects of climate change. Indeed, there is a high degree of convergence and overlap between these complex development challenges. Many countries recognize “population pressure” as an issue for adapting to climate change, but few incorporate family planning into national adaptation planning or poverty reduction strategies. The Inter-governmental Panel on Climate Change (IPCC)- the global scientific body informing the United Nations’ agency for Climate Change, the United Nations Framework Convention on Climate Change, acknowledged the role family planning can play in responding to and adapting to climate change. Improving access to family planning helps save women’s lives by reducing the total number of births per woman and helps reduce birth rates among high-risk groups. Meeting the need for family planning services in areas with both high fertility and high vulnerability to climate change (such as the Sahel region of Africa) can reduce human suffering and help people adapt to climate change. This is also important in wealthier countries like the U.S., where there is unmet need for services as well as high CO2 emissions per capita[i]. It is clear that family planning directly benefits women, their children and families, and there is increasing understanding that furthering women’s rights benefits women and the environment; it’s a win-win. Women with more years’ education have fewer, healthier children and are better able to actively manage their reproductive health. It is precisely in those areas of the world where girls are having the hardest time accessing education that population growth is fastest and environmental degradation is greatest. Addressing these issues together, can kick start a positive chain reaction, improving women and girls’ well-being, while also responding to environmental concerns.
We believe that family planning has many benefits, to all genders, and for social and economic development, and it demands swift and sustained funding and action. Therefore we are pleased that there is increasing recognition of the role family planning can play in adapting to and responding to climate change. As the world prepares for the 23rd global climate change conference, or COP 23, girls’ education and family planning are some of the “unsung” solutions that merit much more attention and credit. However, this has yet to translate into policy or funding changes, nor has it been of much benefit to those living in areas around the world with high levels of unmet need, who are already experiencing the devastating effects of climate change.
The Margaret Pyke Trust, coordinating organization of the Population & Sustainability Network, jointly with conservation organization, the Endangered Wildlife Trust and Pathfinder International, are implementing an integrated family planning and environmental conservation project in the rural community of Groot Marico in the North West Province of South Africa. The community self-identified the need for improved access to general health and family planning information and services, in addition to become better equipped with natural resource management and alternative livelihood skills. On top of poor general health, the community also faces severe land degradation and increasing water scarcity. As part of the project activities, over 200 community members have participated in an integrating training program on Future Planning. The integrated training approach aims to inform community members of the health and gender related benefits of family planning as well as the important role it plays in planning for a sustainable future. Community members learn about the benefits of being able to make informed choices about healthy timing and spacing of pregnancy to ensure good nutrition and a healthy future for their family, while also learning about the importance of sustainable water and natural resource use and alternative and sustainable livelihoods, especially in the face of climate change. Family planning is presented as not only fundamental for women and girls’ health and empowerment but also as an important component of women and men’s future planning, which includes the future of the surrounding environment and the livelihoods that depend on it.
“A Re Itireleng” or let’s do it ourselves- as the community members have named the project- provides an integrated response to this community’s complex development challenges and is an example of a Population, Health and Environment (PHE) Programme. PHE aims to simultaneously improve access to primary health care services, particularly family planning and reproductive health, while also helping communities conserve the critical ecosystems and natural resources upon which they depend. This approach is particularly appropriate for remote, marginalised areas such as Groot Marico, with many barriers to accessing family planning, while also being an area of critical environmental importance which is increasingly threatened by climate change.
As leaders and policy makers prepare to meet in Bonn, Germany for COP 23 we urge them to include family planning in climate response strategies- one of the unsung but highly impactful, human rights based responses to climate change.
[i] Population Action International, New IPCC Report Recognizes Family Planning Among Social Dimensions Of Climate Change Adaptation. Available here: http://pai.org/wp-content/uploads/2014/03/IPCCMediaKit1.pdf